During various procedures performed on ligaments, for example in reconstruction of the anterior cruciate ligament (ACL), it is often necessary to use grafts that can include a number of strands. For example, during an ACL reconstruction, four combined strands are often used, such as two (doubled) gracilis strands and two (doubled) semitendinosus strands. During other procedures performed on ACLs or other ligaments, other grafts can be used instead or in addition, such as patellar tendon, quadriceps tendon, tibialis, and the like. During procedures when more than one strand is used, the multiple graft strands are typically equally tensioned, meaning that the strands are under equal tension, in order to provide optimum biomechanical properties. The tension on each graft strand may be applied by hand one strand at a time, but this approach can make it difficult to achieve equal load on the various strands, can be time consuming, and/or can be challenging to perform. Various other approaches have been taken to apply equal tension, for example by applying weights to each strand or by using various handheld devices, but these approaches can be time consuming, awkward, and/or laborious.
Accordingly, there remains a need for improved methods and devices for tensioning grafts.